[Management of bleeding esophageal varices in public and private institutions in Chile].
BACKGROUND
The better treatment modalities for bleeding esophageal varices have improved the prognosis of cirrhosis.


OBJECTIVE
To inquire about diagnostic and treatment modalities for esophageal bleeding in Chile.


METHODS
An enquiry about diagnosis and treatment of esophageal bleeding was designed and electronically sent to public and private health institutions that could admit patients and were located in cities with more than 100,000 inhabitants.


RESULTS
The enquiry was answered by 31 of 35 public and 17 of 19 private health institutions that were consulted. Emergency endoscopy was available in 6 of 27 public and in the 16 private institutions that had an emergency room. Rubber band was available in 16 public (52%) and in all private institutions. Cyanoacrylate injections were done in 10 public (32%) and 11 (65%) private institutions. No public institution installed transjugular intrahepatic portosystemic shunts, but 8 had occasional access to this technique. This procedure was done in 7 (41%) private institutions and all had access to it. Surgical treatment was feasible in 20 public (65%) and all private institutions. Primary prophylaxis was done in 18 public (58%) and 14 private (82%) institutions. Secondary prophylaxis was carried out in 26 public (84%) and 16 private (94%) institutions.


CONCLUSIONS
Public health institutions have poor access to adequate diagnostic and treatment methods for esophageal bleeding. The primary and secondary prophylaxis of esophageal varices must be improved in both types of institutions.
Vargas T
Ling
L
Hospital San Juan de Dios, Universidad de Chile, Santiago, Chile. lvatank@hotmail.com
Ovalle A
Loreto
L
Morales O
Ximena
X
Agar F
Solange
S
Estay O
René
R
Soto H
Juan Ramón
JR
Armas M
Rodolfo
R
Vergara A
María Teresa
MT
Nazal S
Roberto
R
D002677:Chile; D003487:Cyanoacrylates / Q000627:therapeutic use; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D004724:Endoscopy / Q000706:statistics & numerical data; D004932:Esophageal and Gastric Varices / Q000175:diagnosis* / Q000517:prevention & control / Q000628:therapy*; D019538:Health Care Surveys; D006296:Health Services / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000706:statistics & numerical data; D016304:Hospitals, Private / Q000592:standards / Q000706:statistics & numerical data*; D006779:Hospitals, Public / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D012008:Recurrence
D003487:Cyanoacrylates